4 How Will the ACA Affect the Cost of Health Insurance? *Methodology is Insurance, rather than public health *Essential benefits package is comprehensive Subsidies Individual mandate penalties Reform initiatives

5 Affordable Care Act As Healthcare exchanges open for registration across the country, the Affordable Care Act (ACA) still has a number of hurdles to overcome. Budget battles, information technology concerns, and debate over the employer mandate all feature prominently, while conflicting interpretations of the facts surrounding state-level exchanges continue to distort perceptions of the law.

6 ACA Deadlines Medicaid Payments for Primary Care: Increases Medicaid payments for primary care services provided by primary care doctors to 100% of the Medicare payment rate for 2013 and Implementation: January 1, 2013 through December ON TIME CO-OP Health Insurance Plans: Creates the Consumer Operated and Oriented Plan (CO-OP) to foster the creation of non-profit, member-run health insurance companies. Implementation: CO-OPs established by July 1, 2013 ON TIME Employer Requirements: Assesses a fee of $2,000 per full-time employee, excluding the first 30 employees, on employers with more than 50 employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit. Implementation: DELAYED Basic Health Plan: Permits states the option to create a Basic Health Plan for uninsured individuals with incomes between % FPL who would otherwise be eligible to receive premium subsidies in the Exchange. Implementation: January 1, 2014 ON TIME Limitation on Out-of-Pocket Costs: Limit on out-of-pocket costs, including deductibles and copayments, not to exceed $6,350 for an individual and $12,700 for a family. Implementation: ON TIME

7 ACA Deadlines Multi-State Health Plans: Requires the Office of Personnel Management to contract with insurers to offer at least two multi-state plans in each Exchange. At least one plan must be offered by a non-profit entity and at least one plan must not provide coverage for abortions beyond those permitted by federal law. Implementation: January 1, 2014 ON TIME Accountable Care Organizations in Medicare: Allows providers organized as accountable care organizations (ACOs) that voluntarily meet quality thresholds to share in the cost savings they achieve for the Medicare program. Implementation: UNDERWA Y Medicare Bundled Payment Pilot Program: Establishes a national Medicare pilot program to develop and evaluate making bundled payments for acute, inpatient hospital services, physician services, outpatient hospital services, and post-acute care services for an episode of care. Implementation: UNDERWAY Medicare Tax Increase: Increases the Medicare Part A (hospital insurance) tax rate on wages by 0.9% (from 1.45% to 2.35%) on earnings over $200,000 for individual taxpayers and $250,000 for married couples filing jointly and imposes a 3.8% assessment on unearned income for higherincome taxpayers. Implementation: UNDERWAY

8 Employer Mandate On July 2 nd, the Obama Administration announced that it would push back enforcement of the employer mandate until January 1, White House officials have also said more time was needed to work out information reporting requirements so they would not be too burdensome for businesses. Delaying the mandate also defused a potential political problem for Democrats in next year's congressional elections. The Treasury Department said it will be soliciting feedback on its proposals through early November, and will use the comments to develop final rules. Although the one-year delay of the employer coverage requirement remains in effect, the administration says it hopes employers will voluntarily begin reporting information next year to smooth the transition in 2015.

9 Medicaid Expansion

10 Health Exchanges by State

11 Accountable Care Orgs One of the main ways the Affordable Care Act seeks to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks to coordinate care better, which could keep costs down. To do that, the law is trying an balanced incentive structure in the Medicare program: Accountable Care Organizations. Roughly 4 million beneficiaries are currently in an ACO 428 hospitals nationwide have already signed up An estimated 14% of the U.S. population is now being served by an ACO Pursuant to the ACA, each ACO has to manage the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years.

12

13 Penalties for Uninsured The relatively low penalties associated with the individual mandate make the effectiveness of the mandate uncertain, particularly in the first few years of reform when stability is essential and the penalty can be expected to fall well below the annual cost of the minimum standard of coverage required under the ACA. Oliver Wyman study

on Health Reform Passing comprehensive health care reform has been a priority of the President and Congress. The U.S. House of Representatives passed the Affordable Health Care for America Act on November

SPECIAL BULLETIN Monday, March 22, 2010 This summary is five pages. Summary of Major Provisions in Final House Reform Package The U.S. House of Representatives late yesterday voted to pass landmark health

The Patient Protection and Affordable Care Act ( ACA ) and Your Facility By Christine Garrity: Chief Administrative Officer & General Counsel for The Professional Golfers' Association of America President

FOCUS on on HEALTH REFORM IMPLEMENTATION TIMELINE On March 23, 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act, into law. The following timeline

Health insurance Marketplace What to expect in 2014 Overview The Affordable Care Act (ACA) includes several provisions geared to extend greater access to health insurance benefits to more people. Beginning

How Health Reform Will Help Children with Mental Health Needs The new health care reform law, called the Affordable Care Act (or ACA), will give children who have mental health needs better access to the

Affordable Care Act and Adolescents and Young Adults Overview of Summit Welcome and Introductions Affordable Care Act 101 Affordable Care Act and Impact on Adolescents and Young Adults Federal Update on

The Patient Protection and Affordable Care Act Implementation Timeline 2009 Credit to Encourage Investment in New Therapies: A two year temporary credit subject to an overall cap of $1 billion to encourage

FAQ New Health Insurance Law (Enacted on March 21, signed into law on March 23, and amended on March 25) On March 23, 2010 President Barack Obama signed the Patient Protection & Affordable Care Act (H.R.

Exchange 101 August 2013 455430 27517 Penalties for individuals 2017 and beyond: Annual adjustments 2016: Greater of $695 or 2.5% of taxable income 2015: Greater of $325 or 2% of taxable income 2014: Greater

Health Care Reform: Major Provisions and Bargaining Strategies for Retirees MEDICARE Summary of Benefit: Medicare is the federal government s healthcare program for the elderly and certain disabled individuals.

1 A. Affordable Care Act Individual Mandate The Insurance Mandates of the Affordable Care Act 1. All citizens of the United States are subject to the individual mandate as are all permanent residents and

Hospitals and the Affordable Care Act (ACA) General Housekeeping If you experience any technical difficulties during the webinar, please contact GoToMeeting.com Corporate Account Customer Support at: 1-888-259-8414

The Healthcare Law April 19, 2010 This healthcare bill, recently made law, is a comprehensive overhaul that increases coverage to 94% of Americans and makes sweeping changes to our current healthcare system.

OUTLINE OF HEALTH CARE OVERHAUL LEGISLATION PREPARED FOR AOA MEMBERS BY THE WASHINGTON OFFICE, MARCH 2010 More than 16 months after a far-reaching overhaul of the nation s health care system became the

Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,

Health Care Reform Will Benefit Small Businesses in Massachusetts 1 P a g e WHY SMALL BUSINESSES NEED HELP LESS THAN HALF INSURE WORKERS: Only 45% of America s smallest firms currently can afford to offer

Special Focus Area: The Affordable Care Act - Implications for Bellevue In early 2010, Congress passed and the President signed the Patient Protection and Affordable Care Act. Commonly known as the Affordable

FOR PRODUCERS AND EMPLOYERS Health care reform for large businesses A guide to what you need to know now DECEMBER 2013 CONTENTS 2 Introduction Since 2010 when the Affordable Care Act (ACA) was signed into

Brought to you by Cross Employee Benefits Reporting Requirements for Employers and Health Plans The Affordable Care Act (ACA) created a number of federal reporting requirements for employers and health

Glossary of Health Insurance Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should

Health Insurance Reform Outlook August 2009 by Janet Trautwein CEO, National Association of Health Underwriters Introduction Legislating health care reform in 2009 is the major priority of the Obama administration

What the Health Care Reform Bill Means to Employers No doubt you have heard the news that on Tuesday, March 23, 2010, President Obama signed into law sweeping health care overhaul legislation. This followed

Physician Healthcare Reform Readiness Checklist Tactic Rationale Accept that healthcare change is happening. The current health system model and growth in healthcare expenditures cannot be sustained. We

Health Care Reform and Its Impact on Nursing Practice UNAC-UHCP Convention Las Vegas, NV November 9, 2010 Katherine Cox AFSCME International What Have Your Heard? What Do You Think? How do you think the

Federal Health Reform FAQs Individuals 1. What is an exchange? An exchange, as created under the Affordable Care Act (ACA), is a place where consumers can purchase subsidized health insurance coverage.

Health Care Reform, What s in It? Small Business No. 10 May 2010 Jon M. Bailey Center for Rural Affairs Small businesses dominate the rural economy. In fact, small businesses dominate the American economy

SNHPI Safety Net Hospitals for Pharmaceutical Access Why the 340B Program Will Continue to be Important and Necessary after Health Care Reform is Fully Implemented Since 1992, the 340B drug discount program

1 BEA BRIEFING Affordable Care Act Transactions in the National Income and Product Accounts Benjamin A. Mandel THE PATIENT Protection and Affordable Care Act, often called the Affordable Care Act (ACA),

The shift toward increased collaboration, outcome-based payment and new benefit design is transforming how we pay for health care and how health care is delivered. UnitedHealthcare is taking an industry

A PREVIEW OF MONTANA S HEALTH INSURANCE MARKETPLACE by Gregg Davis and Christina Goe One of the more visible changes soon to be brought to the forefront by passage of the Affordable Care Act (ACA) is the

AFFORDABLE CARE ACT Employers that offer health care coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Most health reform changes apply regardless

HEALTH CARE REFORM DOCUMENT FROM THE WEBSITE OF BLUE CROSS BLUE SHIELD OF NORTH DAKOTA Frequently Asked Questions I ve heard the federal government launched a new website called Healthcare.gov. How can

22 About questions the Affordable Care Act: What Colorado Businesses Need to Know 1 What is the Affordable Care Act? Who is impacted (small, large businesses and self-insured)? The Patient Protection and

www.thinkhr.com AFFORDABLE CARE ACT SMALL EMPLOYER HEALTH REFORM CHECKLIST Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable

Managing and Coordinating Non-Acute Care in an ACO Environment By Glen Roebuck, Vice President of Business Development, Health Dimensions Group Hospital and health care systems across the country are engaging

Exchanges and the ACA What You Need to Know for 2014 How the Affordable Care Act affects the Individual Health Insurance Market This presentation is for informational purposes only and does not constitute

on Health Reform Comprehensive health reform legislation is currently being debated in Congress. On November 7, 2009, the U.S. House of Representatives passed the Affordable Health Care for America Act

FLORIDA HEALTH CARE COALITION Orlando-based 501c3 non-profit, established 29 years ago Provide education, research and program development support to our members Focus on quality improvement, first and

AFFORDABLE CARE ACT Employers that provide health coverage to employees are responsible for complying with many of the provisions of the Affordable Care Act (ACA). Provisions take effect on staggered dates

Consumer Alert Health Insurance for 2014: What You Need to Know Before You Enroll (Individuals) As of January 1, 2014, most individuals must have some form of health coverage, or pay a penalty to the federal

Health Care Reform Legislation and You Timelines and Implications of the New Law for Individuals Updated as of May 2011 Health Care Reform Legislation and You The Patient Protection and Affordable Care

What s in Healthcare Reform for Women-Owned Small Businesses? In March 2010, Congress passed legislation that will fix the serious problems that all small business owners, including those owned by women,

Accountable Care Organization Workgroup Glossary Accountable care organization (ACO) a group of coordinated health care providers that care for all or some of the health care needs of a defined population.

Coverage for Tennessee s uninsured that is market-based, promotes personal responsibility, addresses cost, and is a big step towards real healthcare reform in Tennessee. What is Insure Tennessee? 2 What

This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. A Affordable Care Act Also known as the ACA. A law that creates new options for people

Helbling Benefits Consulting Your Health Care Reform Partner Will you be hit with penalties due to health care reform? Once the employer mandate becomes effective, some employers may have to pay a penalty